RESUMO
We describe a case of a middle-aged woman who presented with progressive jaundice and was suspected to have rebound choledocholithiasis, which was initially managed with balloon extraction through endoscopic retrograde cholangiopancreatography at her first presentation. Healthcare in Pakistan, like many other developing countries, is divided into public and private sectors. The public sector is not always completely free of cost. Patients seeking specialised care in the public sector may find lengthy waiting times for an urgent procedure due to a struggling system and a lack of specialists and technical expertise. Families of many patients find themselves facing 'catastrophic healthcare expenditure', an economic global health quandary much ignored.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica/economia , Coledocolitíase/terapia , Tratamento Conservador/economia , Acessibilidade aos Serviços de Saúde/economia , Icterícia Obstrutiva/terapia , Coledocolitíase/complicações , Coledocolitíase/diagnóstico , Coledocolitíase/economia , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/cirurgia , Tratamento Conservador/métodos , Países em Desenvolvimento/economia , Progressão da Doença , Feminino , Mão de Obra em Saúde/economia , Hospitais Privados/economia , Hospitais Públicos/economia , Humanos , Icterícia Obstrutiva/economia , Icterícia Obstrutiva/etiologia , Pessoa de Meia-Idade , Paquistão , Cuidados Paliativos , Índice de Gravidade de Doença , Tempo para o Tratamento/economia , UltrassonografiaRESUMO
OBJECTIVE: To gauge the general population's knowledge and attitude towards a possible public health insurance scheme. METHODS: This descriptive, cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from April to May 2015, and comprised permanent residents of the city. Convenience sampling was used. Data was collected via questionnaires. SPSS 22 was used for data analysis. RESULTS: There were 340 participants in the study with an overall mean age of 32.9±12.4 years. Besides, 159(46.8%) participants were aware of the concept of medical insurance while the correct definition was identified by 160(50.5%) respondents. Overall, 256(75.3%) participants were willing to join a theoretical public health insurance scheme. Of all the respondents, 107(31.5%) had faced a catastrophic event in the past and consequently were more willing to join. Of those unsure or not willing to join, 33(37.9%) respondents identified lack of trust in government programmes as the main reason for their choice. CONCLUSIONS: A large majority of adults had a favourable attitude towards the implementation of a possible public health insurance scheme.
